title: Influenza infection control guidance provided to staff at Veterans Affairs facilities for veterans with spinal cord injury during a pandemic(†).
abstract: OBJECTIVE
  To assess guidance provided to staff at Veterans Affairs (VA) healthcare facilities on H1N1 influenza infection control for veterans with spinal cord injuries and disorders (SCI/D).
  
  
  METHODS
  Cross-sectional qualitative semi-structured interviews.
  
  
  METHODS
  Thirty-three VA healthcare facilities from throughout the United States that provide care to veterans with SCI/D.
  
  
  METHODS
  Thirty-three infection control key informants, each representing a VA healthcare facility.
  
  
  METHODS
  None.
  
  
  METHODS
  Infection control practices, including vaccination practices, hospital preparedness, and recommendations for future pandemics, both in general and specifically to SCI/D.
  
  
  RESULTS
  Most (n = 26, 78.8%) infection control key informants believed veterans with SCI/D were at increased risk for influenza and complications, but only 17 (51.5%) said veterans with SCI/D were treated as a priority group for vaccination at their facilities. There was little special guidance provided for treating veterans with SCI/D, and most (n = 28, 84.8%) informants said that infection control procedures and recommendations were applied universally. Yet, 10 key informants discussed 'unique challenges' to infection control in the SCI/D population. Informants discussed the potential for infectious agents to be spread through shared and common use equipment and the necessity of including caregivers in any vaccination or educational campaigns.
  
  
  CONCLUSIONS
  Greater input by experts knowledgeable about SCI/D is recommended to adequately address pandemic influenza within healthcare facilities where individuals with SCI/D receive care.
authors.affiliation: Center for Management of Complex Chronic Care, Edward Hines Jr. VA Hospital, Hines, Illinois, IL, USA; and Spinal Cord Injury Quality Enhancement Research Initiative, Edward Hines Jr. VA Hospital, Hines, Illinois, IL, USA.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Locatelli
authors.affiliation: Center for Management of Complex Chronic Care, Edward Hines Jr. VA Hospital, Hines, Illinois, IL, USA; Spinal Cord Injury Quality Enhancement Research Initiative, Edward Hines Jr. VA Hospital, Hines, Illinois, IL, USA; and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, IL, USA.
authors.forename: Sherri L
authors.initials: SL
authors.lastname: Lavela
authors.affiliation: Center for Health Quality, Outcomes, and Economic Research and eHealth Quality Enhancement Research Initiative, National eHealth QUERI Coordinating Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, MA, USA; and Division of Health Informatics and Implementation Science, University of Massachusetts Medical School, Worchester, MA, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hogan
authors.affiliation: Spinal Cord Injury Quality Enhancement Research Initiative, Edward Hines Jr. VA Hospital, Hines, Illinois, IL, USA; and SCI Healthcare Group, VA Puget Sound Healthcare System, Seattle, Washington, WA, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
mesh_terms: D006787:Hospitals, Veterans; D006801:Humans; D017053:Infection Control / Q000379:methods*; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D058873:Pandemics; D012306:Risk; D013119:Spinal Cord Injuries; D014481:United States; D014728:Veterans
chemical_list: D007252:Influenza Vaccines